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Antegrade Retrieval of Ureteral Stents Through an 8-French Percutaneous Nephrostomy Route

Huei-Lung Liang1,2, Tsung-Lung Yang1,2, Jer-Shyung Huang1,2, Yih-Huie Lin1,2, Chen-Pin Chou1,2, Matt Chiung-Yu Chen1 and Huay-Ben Pan1,2,3

1 Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung, 81346 Taiwan.
2 Department of Radiology, National Yang-Ming Medical School, Taipei, Taiwan.
3 Department of Radiation Technology, I-Shou University, Kaohsiung, Taiwan.


Figure 1
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  		Fig. 1A —41-year-old woman with recurrent cervical cancer after antegrade ureteral stent insertion. Fluoroscopic image shows downward migration of ureteral stent (arrow) in upper ureter.

 

Figure 2
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  		Fig. 1B —41-year-old woman with recurrent cervical cancer after antegrade ureteral stent insertion. Fluoroscopic image shows snare catheter introduced into upper ureter to retrieve free end of ureteral stent.

 

Figure 3
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  		Fig. 1C —41-year-old woman with recurrent cervical cancer after antegrade ureteral stent insertion. Fluoroscopic image shows repositioned ureteral stent.

 

Figure 4
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  		Fig. 1D —41-year-old woman with recurrent cervical cancer after antegrade ureteral stent insertion. Fluoroscopic image shows percutaneous nephrostomy catheter reinserted into renal pelvis.

 

Figure 5
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  		Fig. 2A —54-year-old man after percutaneous nephrostomy lithotomy. Fluoroscopic image shows downward migration of ureteral stent (arrow) in upper ureter.

 

Figure 6
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  		Fig. 2B —54-year-old man after percutaneous nephrostomy lithotomy. Fluoroscopic image shows further downward migration of stent into distal ureter (arrowhead) during manipulation. Snare catheter was advanced into bladder to retrieve bladder end of stent (arrow).

 

Figure 7
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  		Fig. 2C —54-year-old man after percutaneous nephrostomy lithotomy. Fluoroscopic image shows ureteral stent retrieved in reversed manner. Pelvic end of stent (arrow) remained in distal ureter.

 

Figure 8
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  		Fig. 2D —54-year-old man after percutaneous nephrostomy lithotomy. Fluoroscopic image shows exchanged ureteral stent.

 

Figure 9
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  		Fig. 3A —23-year-old woman with dysfunction of ureteral stent and history of ketamine abuse. Sonogram shows fine needle (arrowhead) inserted into calyx where end of ureteral stent (straight arrow) was positioned. Debris (curved arrow) fills renal calyx and pelvis.

 

Figure 10
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  		Fig. 3B —23-year-old woman with dysfunction of ureteral stent and history of ketamine abuse. Excretory urogram shows filling defects within calyx (arrowhead). Needle tip (arrow) abuts stent end.

 

Figure 11
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  		Fig. 3C —23-year-old woman with dysfunction of ureteral stent and history of ketamine abuse. Fluoroscopic image shows forceps catheter (arrow) used to grasp stent directly in calyx. Guidewire (arrowhead) is retained in distal ureter.

 

Figure 12
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  		Fig. 3D —23-year-old woman with dysfunction of ureteral stent and history of ketamine abuse. Excretory urogram shows percutaneous nephrostomy catheter.

 

Figure 13
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  		Fig. 4A —70-year-old man after operation for prostate cancer. Cystoscopy failed to pass urethral stricture. Fluoroscopic image shows both snare and forceps catheters failed to retrieve ureteral stent through preexisting percutaneous nephrostomy route in upper renal calyx (arrow).

 

Figure 14
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  		Fig. 4B —70-year-old man after operation for prostate cancer. Cystoscopy failed to pass urethral stricture. Fluoroscopic images show new puncture from lower calyx (arrowhead, B), which made direct contact with pigtail end of stent within renal pelvis. Stent was retrieved with forceps catheter (arrow).

 

Figure 15
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  		Fig. 4C —70-year-old man after operation for prostate cancer. Cystoscopy failed to pass urethral stricture. Fluoroscopic images show new puncture from lower calyx (arrowhead, B), which made direct contact with pigtail end of stent within renal pelvis. Stent was retrieved with forceps catheter (arrow).

 

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